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Obama's health care speech - cutting through the BS
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There was a lot of applause and no shortage of the President's feel-good rhetoric during his speech to a joint session of Congress on Wednesday night (during primetime and televised to a national audience - except on Fox). While the speech was about 53 minutes in length, President Obama got into the meat and potatoes of his health care speech - the part where he finally outlined a concrete plan - about 20 minutes into it.
He made all the important points, but lost in the wash may have been the outline of the President's plan, which was laid out for the first time since his campaign. Here, are what I consider the most important comments of the evening and what they really mean. The President said:
"Under this plan, it will be against the law for insurance companies to deny you coverage because of a pre-existing condition. As soon as I sign this bill, it will be against the law for insurance companies to drop your coverage when you get sick or water it down when you need it most. They will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. We will place a limit on how much you can be charged for out-of-pocket expenses, because in the United States of America, no one should go broke because they get sick. And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies"
Essentially, this means that a new set of laws will be enacted to prevent the insurance companies from dropping individuals for a number of reasons that have made them some of the most reprehensible institutions operating in modern day America. This all sounds good, however, it absolutely reeks of socialism. Giving the government power to regulate private business enterprises will increase the size of government and extend its scope. While this may not actually be socialism, this administration has been no stranger to proposing tenets of socialism as part of its agenda without actually labeling them as such, and it still leaves Obama and company vulnerable on that issue.
From that point Obama went on to say:
"Now, if you're one of the tens of millions of Americans who don't currently have health insurance, the second part of this plan will finally offer you quality, affordable choices…We will do this by creating a new insurance exchange - a marketplace where individuals and small businesses will be able to shop for health insurance at competitive prices. Insurance companies will have an incentive to participate in this exchange because it lets them compete for millions of new customers. As one big group, these customers will have greater leverage to bargain with the insurance companies for better prices and quality coverage. This is how large companies and government employees get affordable insurance. It's how everyone in this Congress gets affordable insurance. And it's time to give every American the same opportunity that we've given ourselves."
This idea would essentially group Americans from around the country (perhaps allowing for the magical cross-state insurance purchase that Republicans have been cooing about lately) into groups defined by their age, health needs and medical history and allow them to buy into insurance plans at a lower price.
Strangely enough, this portion would lump people together, allowing them a union-like buying power, but would also provide private insurance companies the opportunity to fight for the groups in an effort to add more customers to their base. In this particular instance, it would be absolutely imperative to allow customers to buy insurance across state lines.
To make this ideal a reality, customers from different states would need to be lumped together, otherwise the same oligopoly that currently exists in states like Alabama, where the President said one insurance company controls 90 percent of the market, will continue to operate. This was one of the main tenets of Senator John McCain's health care proposal when he ran for President in 2008.
The next part of Obama's plan revolved around the much-maligned public option. Before throwing his support - without an insistence - behind said public option, Obama defined another possibility (at this point, it seemed as though the President's proposal included literally every possible health care proposal) that would keep people from using the public option: tax credits.
"For those individuals and small businesses who still cannot afford the lower-priced insurance available in the exchange, we will provide tax credits, the size of which will be based on your need. And all insurance companies that want access to this new marketplace will have to abide by the consumer protections I already mentioned. This exchange will take effect in four years, which will give us time to do it right. In the meantime, for those Americans who can't get insurance today because they have pre-existing medical conditions, we will immediately offer low-cost coverage that will protect you against financial ruin if you become seriously ill. This was a good idea when Senator John McCain proposed it in the campaign, it's a good idea now, and we should embrace it."
The entire description of the health care necessities seemed aimed at selling the American public on the fact that the public option was not one of those necessities. With regard to the tax credits, it's a good idea but it still just force feeds people to the insurance companies who were supposedly the problem. Once the President actually did get to the public option that he supposedly favors, he made clear that he only wants a tiny minority of Americans to have it:
"An additional step we can take to keep insurance companies honest is by making a not-for-profit public option available in the insurance exchange. Let me be clear - it would only be an option for those who don't have insurance. No one would be forced to choose it, and it would not impact those of you who already have insurance. In fact, based on Congressional Budget Office estimates, we believe that less than 5% of Americans would sign up."
I'm still not sure how only five percent of people would sign up and Obama neglected to mention what this would mean for Medicare and Medicaid, but I suppose those notions are coming. It does beg the question, though, if 45 million people are currently on free, government-sponsored Medicare, how will only 5 percent of Americans -- 15 million -- sign up for the public option?
The President also detailed his newly instituted requirement for everyone in the United States to have some basic form of health insurance:
"Under my plan, individuals will be required to carry basic health insurance - just as most states require you to carry auto insurance. Likewise, businesses will be required to either offer their workers health care, or chip in to help cover the cost of their workers. There will be a hardship waiver for those individuals who still cannot afford coverage, and 95% of all small businesses, because of their size and narrow profit margin, would be exempt from these requirements. But we cannot have large businesses and individuals who can afford coverage game the system by avoiding responsibility to themselves or their employees. Improving our health care system only works if everybody does their part."
Now that the President has actually outlined what he wants to see in a bill, I'm excited to see a reasoned public debate.
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